Provider Demographics
NPI:1225015811
Name:RAMSARAN, EDDISON (MD)
Entity Type:Individual
Prefix:
First Name:EDDISON
Middle Name:
Last Name:RAMSARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-368-3130
Mailing Address - Fax:508-368-3133
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 290 N
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3130
Practice Address - Fax:508-368-3133
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75426207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0103551OtherHEALTHY START
042472266OtherTHREE RIVERS
784072OtherMVP HEALTH CARE
J22626OtherBLUE CARE ELECT
042472266OtherPRIVATE HEALTHCARE SYSTEM
AA4383OtherHARVARD PILGRIM HEALTHCAR
J22626OtherBLUE SHIELD INDEMNITY
MA0103551Medicaid
04247226OtherONE HEALTH PLAN
2500807OtherEVERCARE
042472266OtherTRICARE CHAMPUS
060060854OtherRAILRAOD MEDICARE
457619OtherTUFTS HEALTH PLAN
45823OtherFALLON COMMUNITY HEALTH P
J22626OtherBLUE SHIELD HMO BLUE
0171277OtherCIGNA HEALTH PLAN
042472266OtherHEALTHCARE VAULE MANAGEME
5048284OtherAETNA US HEALTHCARE
J22626OtherBLUE SHIELD HMO BLUE
J22626OtherBLUE SHIELD INDEMNITY